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. 2023 May;42(5):583-591.
doi: 10.1007/s10096-023-04585-x. Epub 2023 Mar 15.

Staphylococcus aureus bacteraemia, cardiac implantable electronic device, and the risk of endocarditis: a retrospective population-based cohort study

Andreas Berge  1   2 , Casper Carlsén  3 , Alexandros Petropoulos  4   5 , Fredrik Gadler  6   7 , Magnus Rasmussen  8   9
Affiliations

Staphylococcus aureus bacteraemia, cardiac implantable electronic device, and the risk of endocarditis: a retrospective population-based cohort study

Andreas Berge et al. Eur J Clin Microbiol Infect Dis. 2023 May.

Abstract

Patients with cardiac implantable electronic device (CIED) and Staphylococcus aureus bacteraemia (SAB) are at risk of having infective endocarditis (IE). The objectives were to describe a Swedish population-based cohort of patients with CIED and SAB, to identify risk factors, and to construct a predictive score for IE. Patients over 18 years old in the Stockholm Region identified to have SAB in the Karolinska Laboratory database from January 2015 through December 2019 were matched to the Swedish Pacemaker and Implantable Cardioverter-Defibrillator ICD Registry to identify the study cohort. Data were collected from study of medical records. A cohort of 274 patients with CIED and SAB was identified and in 38 episodes (14%) IE were diagnosed, 19 with changes on the CIED, and 35 with changes on the left side of the heart. The risk factors predisposition for IE, community acquisition, embolization, time to positivity of blood cultures, and growth in blood culture after start of therapy in blood cultures were independently associated to IE. A score to identify patients with IE was constructed, the CTEPP score, and the chosen cut-off generated a sensitivity of 97%, specificity of 25%, and a negative predictive value of 98%. The score was externally validated in a population-based cohort of patients with CIED and SAB from another Swedish region. We found that 14% of patients with CIED and SAB had definite IE diagnosed. The CTEPP-score can be used to predict the risk of IE and, when negative, the risk is negligible.

Keywords: Bacteraemia; CIED; Endocarditis; Management score; Staphylococcus aureus.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of patients with CIED and SAB
Fig. 2
Fig. 2
ROC curve of the correlation between the CTEPP score and CIED IE in patients with CIED and SAB. Comparison to the performance of the PREDICT-SAB score, also developed in a cohort of patients with CIED and SAB
See this image and copyright information in PMC

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